Massage Techniques for Acute Ankle Sprains

By Chris Foerster, Fremont College School of Wellness

A sprained ankle is a common sports injury. Everyone who's graduated from massage therapy school has likely learned about them. There are several different types of ankle sprains. It can be chronic or acute, and can range from simple to severe. While there might be treatments that could help, no one should ever attempt massage modalities for an ankle sprain, or any type of injury for that matter. That should only be done by a qualified professionalwho meetsthe state’s defined scope and standards of practice for therapy.

For acute ankle sprains, massage therapy may have benefits. After the injury, the standard treatment for an acute ankle sprain tends to be RICE, or rest, ice, compression and elevation. It's always a good idea to respect this as a guideline, as it was developed by professionals.

During the first 24 to 72 hours, there is nothing wrong with a massage therapist laying his or her hands on the injured ankle, depending on your circumstances. This must, however, be done with restraint. The ankle should not be rotated, moved or aggressively touched while it's still tender. Putting hands on the injured party can have benefits. In some cases, it might help calm the injured person down.

As stated above, no one should deviate too far from the standard RICE guideline. But touching it before or after icing is not necessarily a bad idea. Lightly touching the area might provide relief to the injured person, almost as a kind of placebo effect. The process might even give the massage therapist an idea about the extent of the injury at that moment.

After about 72 hours, it's fine to progress to a more standard type of therapeutic massage. For an inversion sprain caused by a rolled ankle, the ligaments may need to be worked in two positions: plantar and dorsi flexion. During this type of massage, the practitioner palpates the ATFL (Anterior talofibular ligament), CFL (Calcaneofibular ligament) or PTFL (Posterior Talofibular ligament) and applies cross-fiber friction to them. This is done for about 20 seconds in each location and each position.

In some cases, it's hard for the masseur to know exactly which ligaments are involved or how all three have been affected. Because of this, some practitioners will massage all three. There's nothing wrong with this as a technique. Some discomfort in the injured ankle might occur, but this process should never be painful. If there is any pain or discomfort the treatment should end right away.

Cross-friction massage may help prevent the formation of scar tissue adhesions and even speed healing. Again, it shouldn't be done immediately following an injury. But it's highly effective after the third day.

Other massage treatments for acute ankle sprains might include lymphatic drainage. This is probably done in addition to applying cross-friction. The cardiovascular system has a pump, the heart, which keeps blood circulating. The lymphatic system doesn't have a pump. When fluid pools due to an ankle sprain, lymphatic drainage might help. Anecdotal evidence has supported its use, and for now, so does the available research. All of these techniques could be taught in massage therapy school depending on the curriculum.